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Declaration of Domicile and Citizenshi ~
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TO THE CLERK OF THE CIRCUIT COURT.
ST. L UC I E COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Fbrida that I am 51ing this day in accordance. and in i
conformity with Section 222.17. Florida Statutes.
I was formerly a legal resident of ~~Q ~7l
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resided at r^, /L , However. I have changed my domicik to
Istrart aad Numlt.rr
and am and have been a bona 5de resident of the State of Fbrida since ,~n~ day of #
4
19~~.. and I reside at 5'9 k ..~,~s~ 1; f
lStseat sad NnmEer)
~c~~ 7` S7`• t ~C / -P ST . l UC I E County. Florida.
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and this statement is to be taken as my declaration of citizenship, actual kgal residence and domiu7e in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STAtE PLEASE CHECK:
THEIR NAMES:
j~~9 OCT IS A~~ il~ 07
FILEO ~hG r:C~litiiiLl
S ROGER
?017R~S: .
CLERK CIRCtl:T COf~R'
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42525
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I FURTHER CERTIFY that I will register at my local address when the ngistntion books reopen, and comply with all
other requirements of a legal resident of thin State.
I FURTHER CERTIFY that I have no intention to return tom former domicile. and I intend to remain in
U C I E County. i
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Florida, permanents; .
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Sworn to an °~F ~ ~ ~fon me this ~ ~ day of
~c.'fo.b a r' A.D.19_ C L v iS ANf~ o ~o ~ g e S F
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RQGER P01 TRAS, CLERK OF G IRGUI T COURT
ST . L UG i E COUNTY, f LOR 1 OA
BY: ~ ~ - _ .
EPUTY LERK '